Maternal and Infant Deaths Reduce in Uganda. Here is Why We Shouldn’t Celebrate Yet
By Namwiza Ritah
KAMPALA – Ugandan women have a big reason to smile. Statistics released recently by the Uganda Bureau of Statistics (UBOS) indicate that maternal and infant deaths have reduced significantly over the past four years.
According to UBOS, infant mortality rate declined from 54 deaths per 1000 live births in 2011 to 43 deaths per 1000 live births in 2016. Similarly, infant deaths reduced from 38 deaths per 1000 live births in 2011 to 22 deaths per 1000 live births in 2016.
This milestone can be attributed to concerted efforts from stakeholders, including the Ministry of Health that saw the number of pregnant women attending antenatal care increase to 60% and more women delivering at facilities.
Yet, despite these achievements, there is still so much more that needs to be done. In fact the critical question that every stakeholder should be asking is, “how do we sustain this momentum?”
The health sector in Uganda continues to be heavily donor reliant and advocacy efforts to have the government increase the health sector budget to 15% as pledged in the Abuja declaration have not yielded much. Although the health sector budget has steadily increased over the years, it still falls way below the 15%.
As a result, the health sector continues to be riddled with persistent problems including inadequate supplies and equipment, drug stock outs, and critical health worker shortages.
The ratio of health workers to the population is especially worrying. In 2014, the Ministry of Health estimated that for every one doctor, there are 24,000 Ugandans to serve. More than a quarter of health sector positions remain unfilled; this worsens in the rural and hard to reach parts of the country which are often shunned by service providers.
Health provider attitudes can also be a major deterrent to access. This is especially true for younger, first time mothers. Stories of women being slapped by midwives because they have failed to push when in labour are not news.
17 year old Najjuma (not real name), is pregnant with her first child. She adamantly refuses to visit a public health facility for fear that the midwives will humiliate her for getting pregnant at such an early age.
“Those midwives can shout at you, asking you why you were having sex at such a young age. If you shout at me like that, how am I supposed to listen to the medical advice you give me?”
Najjuma is a part of the growing number of teenage mothers in Uganda. The 2016 Uganda Demographic Health Survey indicates that 25% of all young women 15-19 have started child bearing and, 19% of all maternal deaths are born by young women in this age group.
There is a need to refocus health programming in order to extend appropriate services to this unique segment of the population. Additionally, the negative attitudes of health workers need to be addressed as a matter of urgency.
We cannot afford to become complacent. We must continue rallying all stakeholders to continue advocating for increased human resources in the health sector, improve working conditions for health workers and increased budgetary allocation to the health sector. This is how we sustain the milestones achieved so far.